Summaries of health policy coverage from major news organizations

Residents of Massachusetts, New York, Connecticut and Rhode Island spent about 15% more on personal health care in 1998 than people living in the rest of the United States, according to a new study in the current issue of Health Affairs, the AP/Philadelphia Inquirer reports. The study, conducted by CMS researchers, also found that residents of Utah, Idaho, Arizona, Nevada and New Mexico had the lowest per-capita health care spending. In comparing costs across the country, the researchers examined the Internal Revenue Service's receipts from for-profit health care businesses, the American Hospital Association's Annual Survey of Hospitals and other data on population, wages and salaries (Carter, AP/Philadelphia Inquirer, 7/9). The state-by-state comparison, last conducted in 1991, found that, nationwide, people spent an average of $3,759 per capita on health care. New England residents spent the most per capita on health care -- $4,540 -- with Massachusetts topping that region's spending at $4,810. Residents of the Rocky Mountain states spent the least -- $3,145 -- with the lowest spending in Utah at $2,731. The study also broke down state spending on Medicare and Medicaid. Massachusetts spent the most per Medicare beneficiary at $6,450, compared with a national average of $5,506. New York topped spending per Medicaid beneficiary at $9,474, compared with a national average of $5,032.

Why the High Costs?

The study cited many possible reasons for the cost discrepancies, including demographic characteristics, incidence of illness, access to and type of insurance coverage, income, availability of resources, local practice patterns, dissemination of "best practices" information and end-of-life treatment decisions (Martin et al., "Health Care Spending During 1991-1998: A Fifty-State Review," Health Affairs, July/August 2002). Anne Martin, the study's lead author, said New England residents paid more in health costs in part because "[u]rban areas in general tend to be higher-priced than rural areas" and because the region "support[s] teaching hospitals and other specialized facilities that can cost more" (AP/Philadelphia Inquirer, 7/9). The Hartford Courant reports that New England residents have "traditionally spent more" on health care because they are "relatively well-insured," which shields them from direct costs and encourages them to seek more services, and because the ratio of physicians to patients is higher than in the rest of the country (MacDonald, Hartford Courant, 7/9). The study's researchers noted that the rates of regional health care spending might not reflect the quality of care. Katie Levit, one of the researchers, said, "People in lower-spending states may be younger, may be healthier, may live in lower-cost areas. It doesn't necessarily mean they're not getting adequate or effective care." The report called for more research on the correlation between health care spending and quality (AP/Philadelphia Inquirer, 7/9).

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